The silicon tracheal T-tube was designed to maintain an adequate tracheal airway as well as to provide support in the stenotic trachea which has been reconstructed. Replacement of the T-tube was obviously undesirable following recent reconstruction of an unstable fracture of the airway. The loss of anesthetic gas through a T-tube while it is in place during anesthesia has been a problem. This report describes a simple method of establishing a satisfactory airway in a patient with a tracheal T-tube, and reviews the anesthesia aspects of modern surgical reconstruction of the larynx and cervical traches.